Applied Health and Social Care Research Centre, College of Health, Wellbeing and Lifesciences, Sheffield Hallam University, Sheffield, UK.
Nurs Inq. 2022 Oct;29(4):e12489. doi: 10.1111/nin.12489. Epub 2022 Mar 13.
To address longstanding workforce shortages, increase efficiency and control the costs associated with the modern health-care provision, there has been a worldwide policy to promote increased flexibility within the health-care workforce. This is being done primarily by extending the 'scope of practice' of existing occupational roles into what is referred to as 'advanced' practice. The development of the advanced practice nurse (APN) has occurred within the context of a shortage of medical staff, and the need to control cost. However, the means by which substantially repurposed occupational groups such as these, are incorporated into complex, hierarchical organisations such as the UK national health service (NHS) remains poorly understood. Using modern sociological theory, the development of the APN role has been examined in terms of power, control, professional identity and gender relations. Each of the theoretical approaches used adds to the quality of the discussion, although none provide a comprehensive picture. However, when synthesised, they do provide an enhanced insight into the evolution of the role. It is argued here that by critically examining the development of the APN role, this will enable both a better understanding of, and the means to influence, its future direction of travel.
为了解决长期存在的劳动力短缺问题，提高效率并控制现代医疗服务提供相关成本，全球范围内的政策一直致力于提高医疗保健劳动力的灵活性。这主要是通过将现有职业角色的“实践范围”扩展到所谓的“高级”实践来实现的。高级实践护士 (APN) 的发展是在医疗人员短缺和控制成本的背景下发生的。然而，如何将这些实质性重新配置的职业群体（例如）融入到复杂的层级组织（如英国国民保健制度 (NHS)）中，仍然知之甚少。使用现代社会学理论，从权力、控制、专业身份和性别关系的角度来审视 APN 角色的发展。虽然每种理论方法都提高了讨论的质量，但没有一种方法提供了全面的图景。然而，当综合起来时，它们确实为角色的演变提供了更深入的见解。这里的论点是，通过批判性地审查 APN 角色的发展，这将使人们更好地理解并能够影响其未来的发展方向。
